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Breast cancer - Still a challenge

In every 4 minutes a new diagnosis and every 13 minutes a death, this is what breast cancer is. Breast cancer is among the most common cancer in woman. In India it is on 2nd after cervix cancer. Now the question is can we change the trend? and answer is big No. We cannot change the trend, but we can manage the late detection of it.

If we look the statistics, initially before the 2008 statistics, cancer of the Cervix was the most common cancer in women in India and Breast cancer was second most common. When the 2008 statistics came out, Breast Cancer overtook Cervical cancer as the most common cancer in Indian cities. But Cervical cancer was still common in rural areas. A rough estimate from the PBCR and HBCCR reports is that the 5 years survival for Breast Cancer in women in India is not even 60%.

Now the question arise is why the survival rate is low?

Answer is well known, most women come to a doctor in advanced stages, and in cancer, the more advanced the stage, the lesser the survival.

Now next question is, why do they come in advanced stages?

Answer is because, they are not 'aware'. Most women do notice symptoms of breast cancer - for example - a painless lump in the breast. But they do not know that this could be cancerous - they are not 'aware'. So, they wait and ignore. Ultimately, the cancerous lump increases a lot in size and also spread, when finally, they realize something is wrong, and come to a doctor. By then, it is fairly late.

So, to increase the survival rate it is important to increase the initial stage diagnosis. Initial stage diagnosis can be increased by the self-assessment of breast.

Two stage self-assessment:

  1. Visual

  2. Physical (Standing and Lying down)

Visual Exam:

A person can do a visual exam in front of a mirror.

With the arms down, check for changes in:

  • shape or size

  • skin color and texture

  • nipple color, texture, and shape

  • vein patterns, especially an increase in the size or number of veins

Repeat these steps with the arms above the head and the body bending slightly forward.

Physical exam while standing up:

People often do a standing exam in the shower because the skin is easier to examine when slippery.

Use the following steps to perform a standing check:

  • With the pads of the three middle fingers, check all parts of each breast using circular motions.

  • Move from the sides to the center, checking for lumps or knots.

  • Repeat using light, medium, and firm pressure. With the fingers, perform circular movements, up-and-down movements, and “wedge” shaped movements from the outer breast to the nipple and back again.

  • Repeat for the whole chest area on both sides.

Physical exam while lying down:

A lying down exam allows the breast tissue to spread out evenly along the chest wall. In this position, a person can check the whole of both breasts and the wider chest area.

  • To check the breast while lying down, follow these steps:

  • To check the right side, place a pillow under the right shoulder and raise the right arm above the head.

  • Using the left hand, press on all areas of the breast and underarm.

  • Repeat with light, medium, and firm pressure. Check with the fingers by performing the same movements as with the standing exam.

  • Cover the area from under the arm to the chest bone, collarbone, and top of the abdomen.

  • Squeeze the nipple and check for lumps and discharge.

  • Repeat all of these steps for the left breast.

Checking the breast

Breast changes that may indicate cancer include:

  • a lump or thickening in the breast tissue

  • an unexplained change in breast shape

  • changes in skin color

  • unusual breast shrinkage or swelling

  • dimpling or puckering of the skin, or enlarged pores

  • skin that has become irritated, scaly, or ridged

  • a thickening of the breast skin

  • pain or a burning sensation

Checking the nipples

Some changes to look for in the nipples and areolae include:

  • changes in skin color

  • warmth or swelling

  • the nipple turning inward

  • a scaly or ridged texture to the skin

  • discharge that could be clear, milky, or yellow or contain blood

  • tenderness or pain

Checking the lymph nodes

Breast cancer can cause changes in the lymph nodes in the early stages.

To check the lymph nodes, look for:

  • a lump, swelling, or thickening around the underarm

  • a lump or swelling in the collarbone area

  • a thickening of the skin in the armpit

Lymph node involvement can also result in a rash on the breast in people with inflammatory breast cancer. A person should contact a doctor about these or any other unexplained changes, especially if they only seem to affect one breast.

Remember All lumps are not cancerous, so don't PANIC.

But any lump can be cancerous, so be ALERT

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